使用腰部CT霍恩斯菲尔德单位预测骨质疏松症:七种机器学习模型的比较性能和临床影响
Akihiko Hiyama1, Daisuke Sakai2, Hiroyuki Katoh2
1Department of Orthopaedic Surgery, Tokai University School of Medicine, Isehara, Kanagawa, Japan. a.hiyama@tokai.ac.jp.
概括
使用腰椎计算机断层扫描 (CT) 和霍恩斯菲尔德单位 (HU) 值的机器学习模型可以有效地选骨质疏松症. K-最近的邻居 (KNN) 显示出平衡的表现,有助于在手术前脊柱手术风险评估.
科学领域:
- 放射学和成像学 放射学和成像学
- 整形外科 整形外科 整形外科
- 人工智能在医学中的应用
背景情况:
- 骨质疏松症查至关重要,特别是在接受脊髓手术的患者中.
- 双能X射线吸收计 (DXA) 是标准的,但在手术前可能并不总是可用.
- 计算机断层扫描 (CT) 扫描为骨密度评估提供了替代的成像方式.
研究的目的:
- 评估从腰椎CT中平均L1-L4霍恩斯菲尔德单位 (HU) 值在预测骨质疏松症中的有效性.
- 用CT衍生HU值来比较多个机器学习 (ML) 模型用于骨质疏松症检测的性能.
主要方法:
- 对172名患者 (≥50岁) 的回顾性分析,包括手术前CT和DXA数据.
- 骨质疏松症的定义是DXA T-score < -2.5 在腰椎或大腿部部.
- 七个监督的ML模型使用L1-L4平均HU作为唯一输入特征开发.
主要成果:
- 59名患者 (34.3%) 患有骨质疏松症,与非骨质疏松症组相比,L1-L4 HU值显著降低 (105.1对140.1).
- K-最近的邻居 (KNN) 显示出最平衡的表现 (准确率:0.714,F1得分:0.466).
- 后勤回归和天真贝叶斯实现了最高的AUC (0.785,0.777),而高风险查的最佳HU值约为90-130HU.
结论:
- 使用CT扫描中的L1-L4HU值的机器学习模型可以有效地帮助骨质疏松症查.
- KNN提供了强大的诊断性能,而物流回归和SVM提供了稳定的分类值.
- 基于CT的ML方法对于手术前脊柱手术评估有价值,特别是当DXA受到限制时.
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